I think it's worth saving! In fact, this is one of those areas I absolutely adore! I purchase old/used/damaged quilts from auctions, when I see I can save them. I find searching for vintage fabric an easy task when replacing pieces within the quilt. As for the back, yes I do replace this as well, and follow the quilting pattern originally used. I also put a binding on, making sure all of the fabric stays within the original pattern. This is one of my greatest challenges, and I love repairing as a second "hobby." This quilt is one I've recently completed. I could not find the butterfly pattern, so I placed the quilt onto my scanner, printed out a copy of the butterfly, and proceeded making my pattern.